Coping with the loss of smell and taste

As I cut a slice of lemon for my tea one morning last March, I found that I could not detect the familiar zing of citrus. Nor, it turned out, could I taste the peach jam on my toast. Overnight, my senses of smell and taste seemed to have disappeared. In the days prior to that I’d had body aches and chills, which I ascribed to a late-winter cold — nothing, I thought, an analgesic and some down time couldn’t take care of. But later that day I saw a newspaper article about the loss of smell and taste in patients with COVID-19, and I realized that I’d likely caught the virus. While I was fortunate enough to eventually recover from it without a trip to the hospital or worse, months after testing negative for COVID, my senses of both smell and taste are still not fully recovered.

In this, I know, I’m hardly alone. According to US News and World Report, 86% of patients with mild to moderate COVID-19 — over six million people, all told — reported problems with their sense of smell, while a similar percentage had changes in taste perception. (Taste and smell work together to create the perception of flavor.) This is in addition to the 13.3 million Americans diagnosed with anosmia — a medical term for the loss of smell — related to other respiratory viruses, head injuries, and other causes. For many of us, improvement has been slow.

Loss of smell affects our health and quality of life

Our senses — smell, vision, hearing, taste, and touch — are bridges that connect us to the world we live in, to life itself. Knock out two of the five bridges, and 40% of our sensory input is gone. Senses add richness and texture to everyday life; they are intricately tied in with our emotions. The loss of smell or taste might not seem as drastic as the shortness of breath or debilitating fatigue that many other people have experienced post-COVID, yet the impact can still be quite demoralizing. You can no longer smell the familiar scent of your loved ones, or taste your favorite dish. Author and poet Diane Ackerman describes these special tastes and smells as “the heady succulence of life” itself.

The loss of smell and taste can also affect our health, causing poor appetite and undesired weight loss. No longer able to enjoy food, patients with anosmia may no longer eat enough, or skip meals altogether. It can even pose an existential threat, by putting us at risk in detecting fires, gas leaks, or spoiled food.

All these impacts help explain why recent studies have linked post-COVID anosmia to depression and anxiety. The jury is still out on whether this has to do with the loss of smell or taste per se — or with the impact of the virus on the central nervous system. One thing we know for sure, however: mood and sense of smell are intricately related. The 5,000-plus members of the Facebook group for post-COVID anosmia sufferers can attest to that. Feelings expressed in their posts run the gamut from mere wistfulness to full-blown grief.

Recovering from the loss

The good news is that olfactory neurons are capable of regeneration. The bad news is that not everyone will return to his or her pre-COVID level of functioning. And, sadly, some of us might never regain our sense of smell or taste at all. According to some experts, patients with post-viral loss of smell have roughly a 60% to 80% chance of regaining some of their smell function within a year. Since the sense of smell usually diminishes due to age, the recovery could take longer and be less than complete for older adults.

Savor what you can experience and engage the mind

To reawaken the olfactory nerves, most specialists recommend smell training, a daily routine of sniffing essential oils such as lemon, eucalyptus, cloves, rose, and others. If you suffer from olfactory loss, don’t be discouraged if some of the essences smell different from what you expected: distortions associated with the loss of smell (troposmia) are not uncommon.

The principle of mindfulness plays an important role here. If you cannot smell the essence at all, try and remember the smell; in other words, engage your mind in evoking the sensation. When eating, if you cannot taste the full range of flavors of a dish, pay attention to the basic ones — sweet, bitter, sour, salty, or umami — as well as to the food’s texture and the sensation on your palate. This will help you focus on what you still can taste, rather than on what you cannot. When I eat dark chocolate, for example, I can taste only the bitter and the sweet; for the flavor of the cacao bean, I still have to rely on my memory.

The old adage, “What doesn’t kill me makes me stronger,” acquires a fresh meaning when applied to the losses associated with COVID-19. These losses challenge us to become more mindful and self-aware, and ultimately, more resilient. We must also learn to be patient and appreciate incremental bits of progress. The other day, for the first time in months, I caught a whiff of citrus in my tea. Lemon never smelled so sweet.

Tips and coping strategies

In my practice with patients with post-COVID losses, and in my own recovery, I have found the following coping strategies helpful.

• Acknowledge your feelings about the loss.
• Consult with an ear, nose, and throat specialist for guidance.
• Consider adjusting your cooking in favor of spicier foods.
• Maintain hope for recovery.
• Cultivate a sense of gratitude: you have survived a potentially lethal disease.
• For additional help, see a counselor or join a support group.

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